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March 1995

Empyema Causing Paralysis of Hemidiaphragm

Arch Pediatr Adolesc Med. 1995;149(3):342-343. doi:10.1001/archpedi.1995.02170150122027

Acquired hemidiaphragmatic paralysis from phrenic nerve injury has been described in a variety of traumatic and surgical conditions, including birth trauma, neoplasms, and complications of thoracic surgery1 and jugular venous cannulation.2,3 We observed the case of an 8-year-old child in whom a temporary paralysis of the left hemidiaphragm developed from an empyema, with eventual resolution in 16 months. To our knowledge, empyema has not been reported as a cause for paralysis of the ipsilateral hemidiaphragm.

Report of a Case. An 8-year-old boy presented to the emergency department with a traumatic puncture wound, 2 cm in length, to the left subscapular region after falling on a tree root earlier that evening. The initial evaluation revealed no foreign body in the chest wall, and the chest roentgenogram was without abnormalities. The patient's wound was treated by primary closure in the emergency department, without surgical exploration. The child returned to the